With today’s article , we return to the theme of the hope factor in Single Session Therapy addressed in the previous article, but from a practical point of view .
The aim of the article is to visualize, through the description of two clinical cases taken from the literature (Courtnage, 2020), the way in which the hope factor acts during the interview .
Before proceeding with the description of the clinical cases, however, let’s review some fundamental theoretical elements!
Snyder (2002) defines hope as a cognitive state whose presence favors people’s ability to pursue their goals. It is the result of the interaction between: mental goals , paths towards the goal and perceived ability to achieve the goal (agency).
Let’s look at the three elements in detail:
Mental Goals: The desire to achieve a goal is seen as a major force in human action (Snyder, 1994). Hope theory states that the act of identifying and naming a goal is sufficient to initiate both thought pathways and agency. Within TSS the clinician’s ability to help clients identify goals is critical (Cameron, 2007; Slive, McElheran & Lawson, 2008; Young et al ., 2012).
Paths to Goals: Snyder (2002) states that path is what allows a person to make design plans to reach goals. People with a high level of hope are more likely to identify multiple paths at once as they are able to foresee potential obstacles towards their goals (Cheaven, Feldman, Gum, Michael & Snyder, 2006). An assumption of TSS is that clients have innate resources and abilities to develop solutions to the problems they are experiencing (Barwick et al ., 2013; Talmon, 2012).
Perceived ability to achieve the goal (agency): Agency refers to the belief in one’s abilities to initiate actions and follow paths towards the goal. In TSS, the promotion of agency involves the valorization of the client’s strengths (Bloom, 2001), constant reflection on his abilities (Hoyt & Talmon, 2014) and the transmission of trust towards change even after a single session (Slive & Bobele, 2011).
Case Study
The two cases of SST reported below were treated through two different forms of intervention. In the first case, the therapist used Narrative Therapy, in the second, however, the intervention was conducted using Solution-Centered Brief Therapy (Courtnage, 2020).
TSS e Narrative Therapy
Ryan is an 18-year-old young man who grew up in a middle-class neighborhood and attends high school outside his area as he is placed in an apprenticeship program designed to enter young people into the workforce immediately after graduation ( Goals ).
Ryan shows up at a walk-in health clinic located within a community-based agency where he is assigned Alanna, a therapist who specializes in Narrative Therapy.
At the start of the session Ryan describes himself as a “pathetic failure”: he tells the story of how, after his father’s death from cancer 5 years earlier, he “didn’t step up” to become “the man of the house”. and helping his mother and older brother, who had been diagnosed with developmental delays. Ryan said his dying father told him to “take care” of them.
He believes that because of his “weakness” his mother has become an alcoholic, his brother does not receive the help he needs and the family lacks financial stability.
Ryan is a month away from graduation and works part-time at a grocery store, but he doesn’t know what he wants to do after graduation. He would like to be helped to choose what to do in the future so that he can help his family and satisfy his father’s wishes ( Goals ).
Alanna asks Ryan what he would like to focus on during the session ( Goals/Agency ). He replies, saying that she would like to “be better” for her family ( Goals ). He says that one day, returning from school, he found her mother sobbing leaning on the kitchen table. Faced with that situation he had tried to comfort her mother, taking care of her brother and preparing a meal ( Percorsi ) to relieve some of the pressure on her.
As Ryan told Alanna all this, she was intrigued by his story and remarked that he was already doing the best he could to make the lives of the people around him easier ( Agency ).
Soon after, Alanna asks Ryan, “If your mother were here, what story could she tell? The version of Ryan taking care of his family? ( Agency ).
Ryan responds that his mother would probably talk about his decision to get a part-time job at 16 and the fact that he often uses the money he earns to buy groceries for the family ( Agency ). Ryan recognizes that without his income there would be times when his family would not have food
( Agency ).
After telling this story, he says he “needs to remember these things” during difficult times ( Paths ) because until then he hadn’t realized the impact it had on supporting his family ( Agency ).
Alanna asks Ryan if this, or any other action, might be helpful in developing further next steps ( Pathways ). Ryan responds that he didn’t realize he was already taking care of his family and that he was thinking it would be a good idea to ask his boss to increase his hours at the grocery store to earn even more money ( Paths ), while he decides what do for the future.
Alanna ends the session by reflecting on how inspired she felt while listening to his story ( Agency ), reminding Ryan that the smallest contribution can make a big difference to those we love ( Agency ).
TSS and Solution Centered Therapy
Ruth is a 32-year-old Canadian-born woman of Afro-Caribbean descent, 16 weeks pregnant with her first child. The child’s father is a white, educated man.
As the woman was walking home from work, she noticed a mental health clinic along the way and thought it might be a good idea to talk to someone ( Objectives ) about an incident that had happened the night before.
Upon entering the clinic ( Percorsi ), she is given a notepad and asked to provide some basic information. One of her questions is: “How will you know you have achieved your goal? Was coming here useful to you?” ( Goals/Agency ). Twenty minutes later Ruth meets Jessie, a therapist trained in TBCS.
After Ruth and Jessie sit down, Jessie asks Ruth “What are your best hopes for what we’re going to think about today?” ( Goals/Agency ). Ruth responds that she feels troubled by her relationship with her spouse and she wants things to be better ( Goals ). She states that she would like to feel more confident and excited about becoming a mother ( Goals ), then adds that the night before she and her husband had an argument that escalated to violence. Ruth said her husband had been violent towards her for many years, but now she worries about bringing a child into this environment, especially since her husband promised her that the violence would stop once she became pregnant with him .
Ruth says she grew up with a physically abusive father and doesn’t want the same experience for her child ( Goals ). Jessie asks Ruth what kind of experience she would like for her son ( Goals ) and she replies that she would like her son to feel safe, protected and loved ( Goals ). Ruth says that she wants to be a good mother ( Goals ), but she doesn’t see how that is possible in the current situation.
Jessie asks her questions about the qualities she possesses that lead her to believe she would be a good mother ( Agency ). She describes being the eldest of three siblings whom she protected from a physically abusive father ( Agency ), taking them away from home as soon as she was old enough to
do so. Ruth says that when she looks back she is very proud of herself for having protected the people she loved ( Agency ). Jessie asks Ruth what difference she has made to her siblings by having her in their lives and Ruth says that they have all completed college or university and gotten jobs ( Agency ). Ruth goes on to say that she is still very close to her brothers ( Agency ), who have expressed concern about her relationship with her husband, suggesting that she leave him. All her brothers offered to give her hospitality if she decided to leave ( Paths ).
Jessie asks Ruth to describe a future in which she feels excited about her pregnancy and being a mother ( Goals ). Ruth describes waking up to an environment where she feels safe, calm and relaxed ( Agency ). Through her detailed description of her, she realizes that this will never be possible if she continues to live with her husband ( Percorsi ). Ruth realizes that she plans to call her sister once she leaves the session and ask her to stay with her ( Paths ) while she develops a plan to keep herself and her baby safe in the future ( Paths ).
Conclusions
The case examples reported illustrate how hope can be activated in clinical practice . Although the SST examples described use different techniques , both sessions were guided by what the client identified as the main goal to achieve in the present and future. This orientation aligns strongly with the basic premise of Snyder’s (2002) hope theory that goal-directed human actions lead to greater hope for overcoming difficulties .
Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center
for Single Session Therapy
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